Healthcare Provider Details
I. General information
NPI: 1225038417
Provider Name (Legal Business Name): HIGHLAND PRIMARY CARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21 HIGHLAND AVE
NEWBURYPORT MA
01950-3872
US
IV. Provider business mailing address
21 HIGHLAND AVE SUITE 2 HIGHLAND PRIMARY CARE ASSOCIATES INC
NEWBURYPORT MA
01950-3872
US
V. Phone/Fax
- Phone: 978-463-7770
- Fax: 978-462-0220
- Phone: 978-463-7770
- Fax: 978-462-0220
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | MA |
VIII. Authorized Official
Name:
ALAIN-MARC
WERNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 978-463-7770